Document Type : Case Report(s)

Authors

• Bolatbek Bimendeevich Baimakhanov ^{1, 2}
• Majid Fasihi Harandi ^{3, 4}
• Shokan Akhmetbekovich Kaniyev ⁵
• Gulziya Nurtazayevna Ismailova ^{5, 6}
• Erik Kumarbekovich Nurlanbayev ⁷
• Chingiz Takhirovich Sadykov ⁵
• Gulziba Muratkyzy ⁸

¹ Chairman of the Board of JSC Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan

² Academician of the National Academy of Sciences, Almaty, Kazakhstan

³ Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran

⁴ Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

⁵ Deepartment of JSC Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan

⁶ Al-Farabi Kazakh National University, Almaty, Kazakhstan

⁷ Department of General Surgery of JSC Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan

⁸ Kazakh National Medical University named after S.D. Asfendiyrov, Almaty, Kazakhstan

Abstract

Rupture of a hydatid cyst can lead to the development of a disseminated form of intra-abdominal cystic echinococcosis if not diagnosed and treated promptly. Anaphylactic shock is a definite indication of cyst rupture. 
The presented clinical case was a young athlete with a disseminated form of cystic echinococcosis, which was investigated in 2023 at the Syzganov National Scientific Center for Surgery of Kazakhstan. The disease developed gradually following a sports injury to the abdomen during sports training and was accompanied by blurred signs of anaphylactic shock. In the next 2 years, echinococcosis of the abdominal cavity was asymptomatic. The clinical manifestation of cystic echinococcosis developed gradually over the last 10-12 weeks, in the form of dull, painful abdominal pain, malaise, weakness, sweating, nausea, poor appetite, and weight loss. Subacute manifestations of the disease resembled those of acute appendicitis. 
A diagnostic laparotomy revealed an abundance of cystic formations in the abdominal cavity, necessitating a differential diagnosis between a disseminated form of abdominal tuberculosis with damage to the mesenteric lymph nodes. However, instrumental verification of the parasite, together with the morphological exclusion of the extrapulmonary form of tuberculosis, made it possible to establish a disseminated form of cystic echinococcosis. The patient underwent a cystectomy, was discharged in satisfactory condition, and was informed about the possibility of disease recurrence. In conclusion, in hyperendemic zones, it is recommended to carry out immunological testing for echinococcosis on all abdominal sports injuries, independent of the presence of anaphylactic shock symptoms.

Keywords

• Echinococcosis
• Hepatic hydatid cyst
• Mesenteric cyst
• Rupture
• Abdomen